The hard part in the Solomons

The measure of success of the Australian-led military intervention in the Solomon Islands lies not in the effusive welcome the Prime Minister, John Howard, received in Honiara yesterday. The restoration of law and order and the surrender of thousands of illegal weapons - without a shot being fired - is a substantial achievement. It is unsurprising Mr Howard's brief visit prompted an outpouring of thanks from the throngs of who lined the capital's streets, waving palm fronds and placards praising Australia. The military intervention, however, may yet prove the easy part.

The respite from chaos can only be translated into a durable peace if the reasons for the failure of governance in the Solomons are honestly addressed. This is especially difficult because serious allegations of debilitating official corruption reach the nation's highest political office, and permeate almost every level of the public service, including the police. Mr Howard's warning that Australia's continued support is dependant on an immediate "full frontal assault" on corruption is appropriate. Whether the political elite has sufficient will to dismantle the very practices which have enriched them is less than certain.

Unravelling the causes of the Solomon Islands' crisis is a multilayered task. The surrender of the notorious militia leader Harold Keke has significantly reduced tensions by removing a threat which justified the bearing of arms by rival militia groups. Keke is a brutal, self-confessed murderer who terrorised the remote Weather Coast of Guadalcanal. His criminal trial is an important step towards justice.

What Keke knows about the sale of logging and fishing rights to foreign companies, however, may prove just an important. The political elite in Honiara, which is dominated by rival Malaitans, has been accused of plundering Guadalcanal's natural resources in exchange for large kickbacks. The Prime Minister, Sir Allan Kemakesa, was forestry minister when Malaysian logging companies began clear felling the fragile tropical forests.

Sir Allan is also accused of improperly receiving hundreds of thousands of dollars of government funds, illegally exporting live dolphins and involvement in a failed assassination attempt. While there is broad support for Keke's arrest and trial, there are also legitimate demands from local populations for control of their natural resources.

Mr Howard's announcement that 17 Australian Treasury officials will assist in resolving the nation's urgent budgetary crisis will go some way to preventing the potential misuse of government funds. The Solomons' Treasury is bankrupt and a cash injection of $25 million from Canberra will restart essential services such as education and health. This should be a one-off gesture. The Solomon Islands is not poor. Since 1978 timber exports have earned $1.9 billion and foreign aid has totalled $1.1 billion. Yet, more than half the Solomons' young men are unemployed and much of this income stream has been brazenly skimmed off by a powerful few. As a Solomons academic, Tarcisius Tara Kabutaulaka, recently said, the best possible result of the Australian-led intervention is to "encourage a capacity for change from within the country".

Keep a lid on pathology fees

It is now the turn of pathologists to warn of dire consequences for the public if the Federal Government does not thicken the Medicare icing when their next five-year funding program begins next July. In doing so, the pathology sector - now concentrated in the hands of three companies, Gribble, Mayne and Sonic - shows a willingness to soften up the Government, if it can, just when the Government is vulnerable. The Government is acutely aware of public fears that the cost of health is getting out of reach of ordinary Australians increasingly obliged to meet co-payments on top of Medicare's scheduled fee. The Government must respond with care once negotiations begin. It should not simply buckle to the pathologists' threats they will walk away from bulk-billing.

The Australian Association of Pathology Practices, which represents about 85 per cent of private practice, makes a persuasive argument in its opening shots to the parliamentary select committee examining Medicare reforms. The AAPP sensibly asks the committee to expand its inquiries beyond GP bulk-billing because there is little point in the Government trying to push that genie back in the bottle if bulk-billing falls apart elsewhere.

With patients paying no upfront costs in 85 per cent of pathology checks, pathologists have the highest bulk-billing rate. But they should not overstate the altruism element in their Medicare record. Mergers and takeovers in the sector, and the application of automation, have delivered to private pathology economies of scale and cuts to overheads that make it ideally placed to benefit from the guarantees of Medicare payment. They are guaranteed the work because GPs increasingly rely on their diagnostic abilities, and they are guaranteed healthy profits from Medicare fees they do not have to pursue through normal commercial methods.

Instead of acknowledging the financial certainty afforded by their $1.4 billion annual share of public funds, the AAPP seeks to claim the high moral ground. It points to a $1 billion "saving" to the public purse achieved by pathologists' restraint. "But this can't go on for ever," says its chief executive, David Kindon.

No one argues that pathologists should bear a disproportionate share of any burden incurred by retaining bulk-billing's public benefits. But honest debate requires acknowledgement that a system of guaranteed, albeit capped, spending on pathology serves the sector's interests as well as those of the public purse. Otherwise, this bid for higher Medicare payments resembles just another ambit claim underwritten by threats of an added burden on patients.